Service order
* mandatory fields
The orderer
Full name:
*
Date of birth:
*
E-mail:
*
Phone
:
Optionals details:
firm, ID No., relation to the deceased, route of transport, description of the ordered service
The deceased person
Full name
: *
Date of birth:
*
ID No.:
*
Date and place of death:*
Place and address of the deceased body:
*
address of the firm
Optional details:
Place of birth, citizenship, nationality, religion, marital status, full name of the deceased person's father and mother (incl. maiden name), contact of the place of burial
By clicking on submit button you agree
with terms and conditions
.
The contract is being made when affirming the order!
